Individual provider Active NPI

J. Brian Same, MD

  • Legal Medicine
  • Buffalo, NY
National Provider Identifier
1043208622
Registry record updated Jan 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Legal MedicineTaxonomy code 173000000X
License
1516221 Issued in NY
Practice address
897 Delaware Ave
Buffalo, NY 14209-2007
Phone
(716) 883-6800
Fax
(716) 883-6853
NPI assigned
Oct 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Legal Medicine 173000000X 1516221 NY Primary

Addresses

Primary practice location

897 Delaware Ave
Buffalo, NY 14209-2007

Mailing address

897 Delaware Ave
Buffalo, NY 14209-2007
Phone (716) 883-6800

Other identifiers 5

IdentifierTypeStateIssuer
00010155901OtherNYUNIVERA
1002486OtherNYINDEPENDENT HEALTH
0046122OtherNYGHI
000502673001OtherNYBLUE CROSS/BLUE SHIELD
01049063MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1516221NYMDLegal Medicine

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294963200000",
    "number": "1043208622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "897 DELAWARE AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142092007",
            "telephone_number": "716-883-6800",
            "fax_number": "716-883-6853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "897 DELAWARE AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142092007",
            "telephone_number": "716-883-6800",
            "fax_number": "716-883-6853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAME",
        "first_name": "J. BRIAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-08",
        "last_updated": "2011-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "NY",
            "license": "1516221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00010155901",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH",
            "identifier": "1002486",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0046122",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "000502673001",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01049063",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.